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Considering Bioidentical Hormone Replacement Therapy?

I have been studying the science of bio-identical hormones for the last 25 years now (yes, they have been around that long – longer, in fact!), and recently they have become quite the rage as a new popular fad.

This is probably because research is showing that when dosed properly, bioidentical hormones are not only a safe way to replace the body’s diminished hormones as we age, but can also help prevent heart disease, stroke and possibly hormone-related cancers.

Another reason for the increased popularity of bioidentical hormones is that there is now more information in the media about their effectiveness, so more people are recognizing that they don’t have to suffer with symptoms like hot flashes, mood swings, memory loss, insomnia, belly fat and loss of muscle mass, which are all associated with decreased hormone production. These symptoms also seem to be increasing, possibly because of the increased amount of environmental toxins that mimic hormones so closely.

If you’re thinking about adding bioidentical hormones to your health regime, I would strongly encourage you to seek out a physician who is highly trained in working with them. Along with the increased popularity and demand for these treatments is the increase in the number of physicians who realize they could improve their bottom line by adding it to their practice. They may take a weekend seminar on bioidentical hormone replacement, but unfortunately learn very little about how hormones actually work in the body.

The endocrine system is very complex and not necessarily easy to understand, but once it’s understood, it’s clear to see how easy it is to throw a patient out of balance by dosing hormones improperly.

For example, sex hormones do not stand on their own; they are in constant communication with all the cells of the body and interact with cellular metabolism. In other words, all of your cells are talking to each other via hormones, which includes glucose and the hormones of glucose management, thyroid function, adrenal function and neurotransmitters, to name just a few. By not having a thorough understanding of how all of these endocrine processes interact with each other, it’s easy to get out of balance by simply adding estrogen, progesterone and/or testosterone.

If you are searching for a physician to help you with this kind of treatment, I suggest you ask them some very simple questions:

  1. What kind of training/education do you have in the functioning of the endocrine system?
  2. Do you take a thorough history and understand all of my symptoms before prescribing a hormone?
  3. How will follow-up monitoring be done?
  4. How will the hormones be prescribed? Will they be in pill form? We do not naturally receive hormones through the digestive tract, so taking them orally is an odd thing for the body. In addition, the liver does not detoxify estrogen and testosterone well, which can make them highly toxic. Progesterone taken orally is converted by the liver to sleep hormones, so if you’re being treated for insomnia due to low progesterone, this can be a wonderful solution, but if you’re needing higher amounts of progesterone in your bloodstream, it may not give you what you need. Topical creams or pellets are the best choices, but if you’re going to use a pellet, make sure you understand that this is a long-term treatment. This means that you will have no control over your hormone dose for three to four months after the pellet is inserted, so if your doctor doesn’t get the dose exactly right, you are stuck with what you get unless you have the pellet surgically removed. Pellets also tend to be a lot more expensive. I have found that using daily topical creams is the best option for most patients. This gives you a lot of options and variability of dosing as your symptoms/body change.
  5. Does your doctor offer you an alternative before starting with a prescription for hormones? Many symptoms and imbalances can be easily resolved with diet, exercise, herbal medicines or supplements, and are much less likely to increase imbalances elsewhere.

Checking out your doctor of choice before you start any kind of therapy can not only save you time and money, but a lot of health issues as well. If you want to know more about whether or not bioidentical hormone therapy is appropriate for you, please feel free to call our office for an appointment. QCBN

By Dr. Susan Godman

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